超声造影和增强磁共振在不同大小肝癌肝动脉化疗栓塞术后的疗效评价

目的:探究超声造影(contrast-enhanced ultrasonography,CEUS)、增强磁共振(contrast-enhanced MRI,CE-MRI)在不同大小原发性肝癌TACE(transcatheter arterial chemoembolization)术后疗效评估的价值与意义,以期为原发性...     

气管支架置入术治疗气管恶性狭窄的并发症分析

目的探讨应用气管支架治疗气管恶性狭窄的并发症。方法回顾性分析1999年11月—2011年6月在局麻和数字减影血管造影机下应用气管支架治疗气管恶性狭窄的25例患者资料,其中6例置入Z型不锈钢支架,19例置入镍钛记忆合金支架,观察支架相关并发症。结果置入Z型不锈钢支架的6例患者中,所有支架置入后即刻完全扩张,2例出现支架移位,随访期中支架再狭窄3例,其中肿瘤增生性狭窄1例,黏稠痰液阻塞性狭窄1例,支架断裂伴肉芽增生性狭窄1例;置入镍钛记忆合金支架的19例患者中,术中无支架移位,2例即刻完全扩张,17例术后3天～3个月扩张完全,随访期内支架再狭窄2例,其中肿瘤增生性狭窄1例,肉芽增生性狭窄1例。所有患者术后呼吸困难即刻明显改善。结论应用气管支架治疗气管恶性狭窄有一定并发症,但仍是一种作用迅速、效果显著的治疗措施。     

三维DSA在腔静脉闭塞型布加综合征诊断和介入治疗中的价值

目的 评价三维DSA(3D DSA)在腔静脉闭塞型布加综合征诊断和介入治疗中的价值.方法21例下腔静脉(IVC)闭塞情况复杂的布加综合征患者经二维DSA(2D DSA)后前位检查确诊后,加做3D DSA检查.由2名介入放射专业主任医师采用双盲法分别阅读2D DSA和3D DSA图像以评价IVC解剖结构,并采用x2检验比较两者对血管的显示情况.根据2D和3D DSA检查结果施行IVC球囊扩张术或支架置入术.结果 所有患者3D DSA均能准确显示IVC闭塞端位置、形态、侧支血管开口及其空间位置关系,检出侧支血管起源于闭塞端9例;2D DSA能显示闭塞端位置、形态、侧支血管开口及其空间关系7例,检出侧支血管起源于闭塞端2例,两者比较差异均有统计学意义(x2值分别为12.07和5.14,P＜0.05).仿真血管内镜成像显示IVC内游离血栓3例、附壁血栓1例.全部患者均治疗成功,1例并发IVC破裂出血,无其他并发症.结论3D DSA在IVC闭塞的诊断中能提供有价值信息,对腔静脉闭塞型布加综合征介入治疗有指导意义.     

肿瘤Ki-67抗原HLA-A2限制性细胞毒性T淋巴细胞表位的鉴定

Objective To identify the HLA-A2-restricted CTL epitopes encoded by antigen segment of Ki-67 for preparation of tumor vaccines. Methods Two epitope prediction databases ( BIMAS and SYFPEITHI) were used to predict the epitopes of Ki-67, and 7 peptides were synthesized as the candi-dates. The prediction was evaluated by peptide-binding test. ELISPOT was used to inspect the IFN-γ secre-ted by CTLs in order to reflect the immunogenicity of the peptides. Results The purities of synthetic pep-tides and positive control peptide were all above 95%. Peptide-binding test displayed that LQGETQLLV (280-288) of Ki-67 could bind with HLA-A2 molecule more strongly. ELISPOT assay displayed that LQGETQLLV could induce activation of specific CTLs. Conclusion LQGETQLLV (280-288) might be the HLA-A2-restricted CTL epitope of Ki-67 antigen.     

表达端粒酶逆转录酶siRNA的溶瘤腺病毒对裸鼠肾癌移植瘤的治疗作用

Objective To investigate the antitumor effect of oncolytic adenovirus armed with small interference RNA targeting hTERT gene for renal cancer therapy. Methods Nude mice were divid-ed randomly into 4 groups (8 mice/group),and were treated by intratumoral injections of ZD55-hTERT ( an oncolytic adenovirus armed with small interference RNA targeting hTERT gene) ,ZD55-EGFP ( an on-colytic adenovirus) and Ad-hTERT (replication-defective adenovirus armed with small interference RNA targeting hTERT gene) with three consecutive daily at 7 × 108 pfu/day or treated with PBS as a control. The expression of E1A and hTERT, and apoptosis of tumor xenografts were assessed by immunohistochemi-cal technique at the 7th day after injections. The tumor volume was measured at the 50th day after injec-tions. Results The tumor volume in ZD55-hTERT treatment group ( 124.1±27.5) was significantly less than that in ZD-EGFP (499.8±77.1 ) and Ad-hTERT ( 609.0±102.5 ) treatment groups. The E 1A pos-itive expression in ZD55-hTERT treatment group was significantly higher than that in Ad-hTERT treatment group. The hTERT positive expression in ZD55-hTERT treatment group was significantly lower than that in Ad-hTERT treatment group. ZD55-hTERT treatment of tumor xenografts resulted in an increased apoptotie cell death as compared with ZD55-EGFP and Ad-hTERT treatment. Conclusion The antitumor effect of ZD55-hTERT was more potent than oneolytie adenovirus ZD55-EGFP and Ad-hTERT.     

经肝动脉化疗栓塞联合经皮微波消融序贯治疗早期肝癌的疗效及预后影响因素

目的：探讨早期肝癌经肝动脉化疗栓塞(TACE)联合经皮微波凝固消融(PMCT)序贯治疗后的临床疗效及预后影响因素。方法2011年1月—2014年4月收集早期肝癌患者66例,先行TACE,5~7 d后在超声引导下行PMCT。分析术前、TACE和联合PMCT治疗后肝功能、甲胎蛋白(AFP)的变化。Kaplan-Meier计算无瘤累积生存率,Chi-square分析影响复发的高危因素,有统计学意义者引入logistic回归多因素分析。结果66例早期肝癌TACE后较术前ALT、TBIL、DBIL显著升高(P<0．01);联合PMCT后较术前AST、ALT、DBIL升高(P<0．01);联合PMCT后与TACE相比,AST升高(P<0．01), TBIL、DBIL降低(P<0．01)。联合PMCT与术前、TACE相比AFP均降低(P<0．01)。本组病例随访期间死亡1例,3年累积生存率98．5%。复发19例,1、2、3年的无瘤累积生存率分别为70．3%、50．8%、41．6%。单因素和多因素分析AFP≥100μg/L、病毒载量≥103拷贝/ml和肿瘤边界不规整是早期肝癌联合治疗后复发的危险因素(P<0．05)。结论 TACE联合PMCT序贯治疗是早期肝癌较理想的治疗方法,TACE后序贯PMCT不会影响肝功能恢复进程,AFP≥100μg/L、病毒载量≥103拷贝/ml和肿瘤边界不规整是早期肝癌TACE联合PMCT序贯治疗后复发的危险因素。     

表达端粒酶逆转录酶siRNA的溶瘤腺病毒对裸鼠肾癌移植瘤的治疗作用

Objective To investigate the antitumor effect of oncolytic adenovirus armed with small interference RNA targeting hTERT gene for renal cancer therapy. Methods Nude mice were divid-ed randomly into 4 groups (8 mice/group),and were treated by intratumoral injections of ZD55-hTERT ( an oncolytic adenovirus armed with small interference RNA targeting hTERT gene) ,ZD55-EGFP ( an on-colytic adenovirus) and Ad-hTERT (replication-defective adenovirus armed with small interference RNA targeting hTERT gene) with three consecutive daily at 7 × 108 pfu/day or treated with PBS as a control. The expression of E1A and hTERT, and apoptosis of tumor xenografts were assessed by immunohistochemi-cal technique at the 7th day after injections. The tumor volume was measured at the 50th day after injec-tions. Results The tumor volume in ZD55-hTERT treatment group ( 124.1±27.5) was significantly less than that in ZD-EGFP (499.8±77.1 ) and Ad-hTERT ( 609.0±102.5 ) treatment groups. The E 1A pos-itive expression in ZD55-hTERT treatment group was significantly higher than that in Ad-hTERT treatment group. The hTERT positive expression in ZD55-hTERT treatment group was significantly lower than that in Ad-hTERT treatment group. ZD55-hTERT treatment of tumor xenografts resulted in an increased apoptotie cell death as compared with ZD55-EGFP and Ad-hTERT treatment. Conclusion The antitumor effect of ZD55-hTERT was more potent than oneolytie adenovirus ZD55-EGFP and Ad-hTERT.     

Ki-67启动子的克隆及其转录活性

目的 克隆肿瘤特异Ki-67启动子,观察其在人肿瘤细胞中的转录活性.方法 提取肾癌Ketr-3细胞基因组总DNA作为模板,聚合酶链反应(PCR)获取1.6 kb的Ki-67启动子DNA片段.克隆到pGL3-Basic载体构建双荧光素酶检测质粒pGLB-Ki-67.将pGLB-Ki-67转染4种人肿瘤细胞及人脐静脉内皮Huvec细胞,使用双荧光素酶检测系统鉴定启动子活性及肿瘤特异性.结果 电泳与测序结果 显示克隆出的Ki-67启动子片段序列与Genbank中记录一致,pGLB-Ki-67质粒构建成功.其启动子活性在Hela、BIU-87、Ketr-3、A549 4种人肿瘤细胞内分别达到SV40 promoter/enhancer活性的21.0%、31.1%、23.9%和7.2%;在Huvec细胞内仅为0.5%.结论 克隆出I(5-67基因启动子(-820～+771),并证明其具有良好转录活性.     

肿瘤Ki-67抗原HLA-A2限制性细胞毒性T淋巴细胞表位的鉴定

目的 鉴定Ki-67抗原HLA-A2限制性细胞毒性T淋巴细胞(CTL)表位,为制备肿瘤疫苗提供依据.方法 根据BIMAS和SYFPEITHI数据库对人Ki-67抗原CTL表位综合评分结果,合成7条候选肽.通过T2-肽结合实验检测候选肽与HLA-A2分子亲和力;通过酶联免疫斑点法(ELISPOT)检测HLA-A2阳性CTL细胞分泌IFN-γ能力,评价候选肽免疫原性.结果 合成的候选肽及阳性对照肽HIV-1 pel 476-484纯度均超过95%.T2-肽结合实验结果显示280～288位置Ki-67氨基酸序列LQGETQLLV与HLA-A2分子结合力较强,其能够诱导特异性CTL活化.结论 LQGETQLLV(280～288)是Ki-67抗原的HLA-A2限制性CTL表位.